236 SCOPE-KIDS: feasibility study of a collaborative care model for delivering youth urgent mental health care
Notice bibliographique
Résumé
Introduction In Ontario, Canada, a significant proportion of youth reported mental health challenges in 2019, with nearly 25% experiencing moderate to severe anxiety or depression and almost 20% seriously considering suicide. The COVID-19 pandemic further exacerbated these issues, leading to a 10–15% increase in mental health service utilization and consequent increases in wait times for child/adolescent mental health services. Service gaps widened, and primary care physicians often had limited knowledge of available resources, while access to allied health supports was restricted for those not affiliated with family health teams.Methods To address these challenges, the SCOPE-KIDS pathway was developed as a joint quality improvement initiative between the Sunnybrook Department of Psychiatry and the North Toronto Ontario Health Team. The initiative aimed to expand mental health service delivery and navigation for children and youth. The development and implementation of SCOPE-KIDS took place over one year and involved multiple external stakeholders, including PCPs, child/adolescent psychiatrists, administrative leaders, QI experts, navigational experts, and a patient/family advisory group. The formation of the initiative was guided by Kotter’s framework in leading change. The SCOPE-KIDS team identified four primary goals: (a) improving time to access SCOPE KIDS service, (b) reducing time to physician-based mental health assessments to less than 4 weeks; (c) providing measurement based care; and (d) providing appropriate follow up matched to patient’s disease severity.Results After 20 months, SCOPE-KIDS handled a total of 115 mental health referrals, all received through a mental health navigator and triaged appropriately. Services provided included direct psychiatric consultations, MD-to-MD (indirect) consultations, social work consultations, and community system/resource navigation. 68 out of 115 referrals involved psychiatric consultations by adolescent psychiatrists, and the vast majority of cases (99 out of 115) were based in the City of Toronto. 55 unique PCPs utilized the service, with an average time from referral to first contact of 3 days. Where requested, 79% of cases consulted with a social worker within 1 week of referral and 77% with a psychiatrist within 1 month. The average age of clients referred was 13.3 years. Around 62% of psychiatric consults included a diagnosed anxiety disorder, 34% had an attention or learning disorder, 24% a mood disorder, and 8% a neurodevelopmental disorder like ASD. Few follow-ups were needed beyond the initial consultation.Conclusions The interventions implemented through the SCOPE-KIDS pathway highlight the importance of multidisciplinary collaboration and the need for accessible mental health resources for youth with limited wait times. The successful implementation of this model in one community suggests that other healthcare settings and teams can replicate it to begin bridging service gaps and meeting the rising mental health needs of youth in their communities.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,023 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,001 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».